The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture
by Richard J. Degrandpre
America's Love Affair with Drugs
A review by Andrew Benedict-Nelson
Anyone who has ever quit smoking soon discovers that gaining weight is often an unavoidable part of the deal. In 2001, the United States seemed to experience this realization on a collective level, as the Surgeon General, who many Americans had last encountered in a warning on their last pack of Marlboros, foretold a different sort of public health crisis: a national obesity epidemic.
It hardly seemed fair. Cigarettes, after all, had recently been exposed as delivery devices for a highly addictive and unnatural blackguard of a drug: nicotine. And while certain parties began to point fingers at trans fats or carbs, there was simply no nefarious substance to blame for obesity. It really was just too much of a good thing, food.
But perhaps we had set ourselves up for this frustration. Perhaps our obsessive pursuit of criminal chemicals -- not just nicotine, but its nastier cousins meth and crack -- had blinded us to more fundamental problems weighing down our society. This is the thesis advanced by Richard DeGrandpre in his book The Cult of Pharmacology: How America Became the World's Most Troubled Drug Culture. In particular, DeGrandpre argues that Americans have an almost religious faith in the chemical essence of "demon drugs" (as well as "angels" like Ritalin and Prozac) while completely ignoring the social circumstances in which these avatars intersect with flesh.
Cigarettes are the example most accessible to the average American, and DeGrandpre has no trouble burning a hole through the traditional narrative of nicotine withdrawal. Studies of people trying to quit smoking do not show a clear correlation between the amount of nicotine they once consumed and the difficulty of quitting, he writes; instead, factors like personality play a much stronger role.
These facts are corroborated by the history of cigarettes, which only enjoyed their greatest popularity when tobacco companies had successfully minimized and masked the nicotine in their product. The addictive potential of the drug might have been part of the reason Americans had been hooked for so long, but DeGrandpre suggests that the ubiquity of the cigarette, its insinuation into every culture and color and class, might have just as much to do with it.
These cultural factors become much more significant when applied to "hard" drugs like cocaine -- and, as DeGrandpre would like to suggest, Ritalin. As long ago as 1975, DeGrandpre writes, scientists could show that rhesus monkeys preferred Ritalin and cocaine equally when given unlimited quantities, suggesting that the drugs produce similarly pleasurable and addictive effects. More than two dozen studies since have documented that the two drugs yield similar outcomes in animals. Why, then, has cocaine become a "demon" and Ritalin an "angel"?
DeGrandpre suggests that cultural and social factors make the difference. Cocaine is stereotypically thought of as being used by junkies and criminals. There is no "right" way to use it, as shown by the American government's hostility toward even the traditional chewing of coca leaves in South America. Ritalin, on the other hand, is a parent's friend. Perhaps more importantly, it is legally produced by a lab, packaged as a product, and ingested as a time-delayed pill. As soon as Ritalin is crushed and snorted for an immediate high, it also gains a stigma. If Ritalin and cocaine are equivalents, this might seem fair -- until you imagine what would happen to a parent if they encouraged a child's coke habit to improve an SAT score.
As DeGrandpre's similar investigation of antidepressants makes clear, this division of substances into sinners and saints is doing very little to help solve America's actual problems, chemical or cultural. He suggests that we stop focusing so much on the molecular nature of drugs and look at the circumstances in which they are used.
Indeed, the scientific and sociological data that buttress this argument are the most interesting part of the book. For instance, DeGrandpre cites studies that show that the availability of a sweet food alternative significantly reduces monkeys' chances of becoming addicted to cocaine in a controlled environment. Experiments with rats show that while animals will indefinitely seek a voluntary electrical stimulation to the "pleasure centers" in their brains, they resist a similar involuntary shock.
Skeptics may say that such studies tell us little about the complex situation of human drug use, but DeGrandpre convincingly turns this argument on its head. If such simple changes in environment can overcome the chemical "essence" of a drug in animals, think what sort of complex social and cultural factors must come to bear on human beings' altered states. For the holdouts, DeGrandpre also offers some surprising sociological data. Consider, for instance, that while thousands of soldiers in the Korea and Vietnam wars became casual opium users overseas, very few of them remained addicts at home. The message of such data is not that every good American ought to smoke a bowl. It's that the policy that's presented as the American ideal -- zero tolerance -- is simply too obtuse to tolerate.
A more significant shortcoming of DeGrandpre's book is his failure to consider the future of America's troubled drug culture. Instead, we're left with an inadequate postscript in which DeGrandpre name-checks Edward Said and Michel Foucault but never really posits a theory about why our society has gone so wrong. While he ably demonstrates America's faith in the essences of drugs, DeGrandpre fails to give a compelling explanation for why so many parents are willing to sacrifice the minds of their children to the "cult," or the weird disconnect that allows our government to deploy toops overseas to block the drug trade yet turn a blind eye to the pharmaceutical industry at home.
Perhaps that's an unfair critique of what is, on the whole, an insightful book on the difficult subject of drugs. But if DeGrandpre is right -- and if trends like our obesity epidemic continue -- we may discover that our drug troubles are only a symptom of what ails us.
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